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other one is the depressed sweating type, in which Ach directly acts on mast cells. 6 In the former type, patients develop wheals in response to sweat substance leaking from the syringeal ducts to the dermis. In the latter type, we found that CholU with anhidrosis and hypohidrosis (CUAH) lacks cholinergic receptor M3 expression in eccrine gland epithelial cells. 6 CholU with angioedema is characterized by sweat allergy, female dominancy, concomitant presence of atopic dermatitis, and high frequency of anaphylaxis. 2 Instead of palpebral swelling, lip swelling was prominent in our case.Antihistamines are mostly ineffective in CholU. In several cases, omalizumab has been reported as useful therapy for CholU. 7-9 Our case also documented the effectiveness of omalizumab for both CHolU and the associated symptom of angioedema.